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Adrenergic drugs are a broad class of medications that bind to adrenergic receptors throughout the body. These receptors include: alpha-1, alpha-2, beta-1, beta-2, beta-3. Adrenergic drugs will bind directly to one or more of these receptors to induce various physiologic effects. Adrenergic drugs must be classified based on the specific receptors they bind. This activity examines the pharmacology, various therapeutic effects, and adverse events that class members can exert, which covers a wide variety of clinical manifestations. Objectives: Identify the various actions of adrenergic medications based on the receptor to which they bind. Describe the various adverse effects of adrenergic drugs based on the binding site. Review the contraindications to various adrenergic drugs based on their preferred binding sites. Outline the importance of collaboration and coordination among the interprofessional team leading to improved patient care when using adrenergic agents. Access free multiple choice questions on this topic.

Adrenergic receptors all have drug antagonists. Alpha-blockers are not generally indicated for the treatment of alpha-agonist overdoses. Beta-blockers may be used to treat adverse effects arising from adrenergic receptor agonists acutely. Beta-blockers can treat tachycardia and hypertension that may occur from vasopressors. Toxicity should be monitored in the pediatric population when using beta-2 agonists as they can increase liver aminotransferase concentrations.[25] In addition, when prescribing alpha-2 agonists, there are instances where angioedema, atrioventricular (AV) block, and hypersensitivity may occur. Potential toxicities of beta-1 agonists may include tremors, headaches, and vomiting.[19][20]

There are many types of adrenergic agents, and clinicians, including physicians, nurse practitioners, and physician assistants who prescribe these agents, should be aware of their side effects and contraindications. Management requires an interprofessional team approach to drug therapy with these drugs since they cover such a broad spectrum of indications and effects, both therapeutic and adverse. It is essential to consult with a pharmacist if there is any question about the use of an adrenergic agent; this can include drug-drug interactions, appropriate dosing based on the condition treated, and adverse event profile. Nurses can also access this resource as they will often administer the drugs inpatient and will need to know what signs to watch for in the event of an adverse reaction of any sort. All interprofessional team embers must document any changes in patient status in the patient's medical record and communicate their findings to other team members so therapeutic adjustments can be made. An interprofessional team approach is vital to coordinate the care of patients taking these medications safely and effectively. [Level 5]